Pediatric chronic abdominal pain is one of the most common symptoms in pediatric practice. Approximately 10% of children in clinical practice have visited hospitals or clinics for different forms of chronic abdominal pain. Due to the lack of other specific manifestations, many children with chronic abdominal pain often suffer from long-term pain without clear diagnosis and effective treatment, which seriously affects their normal physical and mental development and quality of life. In recent years, Biliary Dyskinesia has received a lot of attention from pediatricians and gastroenterologists, leading to the diagnosis and treatment of some children with chronic abdominal pain. Gallbladder dyskinesia has been studied in adults for more than 20 years, and cholecystectomy is performed to relieve symptoms after a definitive diagnosis. Recent studies have demonstrated that laparoscopic cholecystectomy is effective in relieving clinical symptoms in more than 90% of patients. In contrast, research on gallbladder motility disorders in children has only recently gained attention, and several authors have studied the effectiveness of postoperative relief after cholecystectomy or laparoscopic cholecystectomy in children. Although strong evidence for long-term relief of symptoms is still lacking, gallbladder dyskinesia has been listed as a common indication for cholecystectomy or laparoscopic cholecystectomy and is recognized by most pediatric clinicians. 1. Characteristics of gallbladder dysmotility: Gallbladder pain caused by gallbladder dysmotility is chronic abdominal pain, and the diagnosis is made only when underlying calcified gallbladder stones, esophageal reflux disease, and ulcer disease are excluded. The abdominal pain is often characterized by postprandial right upper abdominal pain, fatty diet intolerance, nausea, and abdominal distention, which is why the disease was also called Chronic Acalculous Cholecystitis in its early stages. Gallbladder motility disorder was first reported by Westphal in 1923 as a dysfunctional disorder of the autonomic nervous system of the gallbladder. It is characterized by symptomatic biliary colic caused by abnormal gallbladder contraction. Since the introduction of cholecystokinin-stimulated nuclear scanning in 1981, objective indications for the functional examination of the gallbladder have become available. Gallbladder contractin-stimulated hepatic iminodiacetic acid nuclear scan (CCK-HIDA) or cholecystokinin-stimulated diisopropyliminodiacetic acid nuclear scan (CCK-DISIDA) can now be used to assess gallbladder emptying capacity to assist in diagnosis. Most studies have reported that after performing CCK-HIDA or CCK-DISIDA, when the gallbladder bile emptying rate is less than 35% in 1 hour, it can be considered that gallbladder motility disorder is present and cholecystectomy is appropriate. The pathogenesis of this disease is unclear, and potential causative factors include spasm of the sphincter of Oddi and abnormal development of the cystic duct, which may be associated with uncoordinated contraction and diastole of the gallbladder and the sphincter of Oddi, ultimately leading to gallbladder dilatation, inflammation, hyperresponsiveness, and motility dysfunction. Recently, the relationship between inflammatory cells in the gallbladder wall and gallbladder motility disorders has been explored, and the morphology of the gallbladder has also been studied in depth by MR imaging, and work in this area will certainly provide a theoretical basis in elucidating the pathogenesis of gallbladder motility disorders. 2.Gallbladder dyskinesia in childhood: In recent years, the number of diagnoses of gallbladder dyskinesia in children has increased substantially, which is due to the increased use of CCK-HIDA and CCK-DISIDA due to the further understanding of the disease. Foreign studies have shown that the majority of this disease occurs in children or adolescents between the ages of 5 and 18 years and is more common in girls. Due to the lack of specific clinical symptoms and specific laboratory and imaging findings, the disease is often diagnosed after 1 year or even longer after the onset of the disease. Dumont and Caniano were the first to report 42 cases of gallbladder dysmotility in children, of which more than 90% were relieved by cholecystectomy. More studies on gallbladder dysmotility in children have been reported since then, but the diagnosis and outcome of this disease are more controversial. Therefore, the possibility of gallbladder dysmotility should be considered in right upper abdominal pain presenting after a meal, with the exception of gallbladder and bile duct stones on abdominal ultrasound. Right upper abdominal pain, nausea and vomiting are the typical triad of gallbladder motility disorders, but only about 50% of children present with the triad at the same time, and about 2/3 of these patients have both right upper abdominal pain and nausea. The gallbladder bile emptying rate obtained by cholecystokinin-stimulated nuclide scan is an indicator of gallbladder function, and an emptying rate of less than 35% within 1 hour is considered to have gallbladder motility disorder, however, further studies are needed to determine how much less than this rate is appropriate for surgery, and Carney considers an emptying rate of less than 15% to be an indication for laparoscopic cholecystectomy. Although most studies have shown that cholecystectomy relieves more than 80% of children’s symptoms at short-term follow-up, the rate of relief decreases to about 50%-75% at long-term follow-up. In particular, randomized controlled studies have shown that the rate of symptom relief in the control observation group was similar to that of the treatment group, with no significant difference. Only the duration of symptom remission in the observation group was about 20 months, which was significantly longer than the 11 months in the treatment group. This result indirectly proves the self-limiting nature of the disease. It has even been suggested that if there is Oddi’s sphincter dysfunction, performing cholecystectomy diminishes the bile reserve capacity and worsens the symptoms instead. Therefore, a randomized controlled prospective study of this disease in a large number of cases is essential to resolve the above controversy. In addition, there are few reports on the medical treatment of this disease, which mainly focuses on the relief of symptoms by nonspecific treatments such as antispasmodic, cholagogic, and anti-inflammatory. In conclusion, the disease of gallbladder dysmotility in children characterized by chronic abdominal pain has received greater attention in recent years. However, the recognition and research of this disease in China has not yet received sufficient attention. In the majority of children’s hospitals, the diagnosis of this disease is rarely made clinically, and it is not described in common pediatric textbooks and reference books, and there is a lack of first-hand information on the assessment and study of gallbladder motility in children in China. Therefore it is urgent to make more pediatricians aware of this disease.